AB 301 creates a new grant program providing up to $300,000 annually for mental health clubhouses - nonresidential support programs for individuals with mental health conditions (not medical treatment providers). Eligible clubhouses must meet specific criteria, including having members diagnosed with or awaiting diagnosis for mental illness, raising matching funds equal to the grant amount, operating in a separate physical space, and allowing member participation in operations. Grants are capped at $50,000 per clubhouse per year, with all funding expiring by June 30, 2030. This bill directly affects qualified clubhouses seeking financial support to maintain their services.
AB 104 prohibits health care providers from performing or referring minors under 18 for medical interventions intended to change their physical characteristics to match a gender different from their biological sex. It specifically bans surgeries (like hysterectomy or orchiectomy), mastectomies, puberty-blocking drugs, and high-dose cross-sex hormone treatments. Exceptions apply for genetic disorders of sex development, treating complications from prior procedures, or immediate life-threatening conditions. Violations could result in license revocation for health care providers by the licensing board.
AB 163 requires regular eligibility reviews for the Medical Assistance program (a public health benefits program) every six months, replacing automatic renewals. Recipients must report changes affecting their benefits within 10 days or face a six-month loss of coverage. The bill mandates state agencies to cross-check public benefit databases against death records and other state databases (like employment or prison records) every three months to remove deceased individuals and verify eligibility. It also establishes data-sharing agreements between agencies to confirm applicant information using sources like federal benefit records, with all eligibility reviews required to be completed by January 1, 2026.
SB 83 creates exceptions to prior authorization requirements for antipsychotic drugs under the state's Medical Assistance program (Medicaid). It specifies four situations where prior approval isn't needed for recipients aged 18+: if the drug was previously approved at a different dose, the recipient was recently enrolled after 30 days of continuous use, prior authorization expired after 60 days of continuous use, or the recipient was stabilized on the drug after a recent hospital discharge. The bill does not override federal Medicaid rules. It directly affects Medicaid recipients prescribed antipsychotic medications who meet these specific criteria.
Senate Bill 174 establishes state regulations for health plans regarding preexisting conditions and benefit limits. It would prevent individual and group health plans from denying coverage or imposing exclusions based on an individual's preexisting health condition. The bill also prohibits lifetime and annual dollar limits on benefits and sets rules for how premium rates can vary for individual and small employer plans. These provisions would only take effect if federal Affordable Care Act regulations related to these issues are no longer enforceable or preempt state law.
SB 373 limits health insurance plans' use of prior authorization for physical therapy, occupational therapy, speech therapy, and chiropractic care. It prohibits requiring prior approval for the first 12 visits per condition (or 90 days for chronic pain management at up to twice weekly visits) and mandates equivalent copays to primary care. Insurance plans must explain coverage denials in plain language and decide on reauthorizations within 3 business days (or approval is automatic). This directly affects health insurance plans and patients seeking these specific therapies in the state.
SB 311 prohibits state and local government funds - including those from counties, cities, towns, and federal funds passing through the state treasury - from covering health care services for individuals not lawfully present in the U.S. It directly affects undocumented immigrants seeking health care in Wisconsin. The bill creates a new statute (20.926) banning such funding, with two exceptions: it does not apply if federal law requires payment, or if applying the ban would cause the state to lose federal funds. This policy change restricts public funding for health services based solely on immigration status.
SB 108 creates a secure online portal to share minors' safety plans during mental health or behavioral crises. It allows minors (13+) to create written plans with a facilitator, including contact info, de-escalation strategies, and crisis guidance, which they can share only with designated safety plan partners (like schools, law enforcement, or health providers) after signing a consent form. The portal, managed by the state, requires minor consent for sharing, limits access to crisis situations or updates, and expires after one year. This directly affects minors at risk of crisis encounters with emergency services and the agencies coordinating their care. The bill standardizes how safety information is shared while requiring explicit consent and confidentiality.
AB 299 requires the University of Wisconsin (UW) System Board to contract with a mental health service provider for virtual counseling and support for students at UW institutions with 30,000 or fewer full-time undergraduate students (as counted April 1 annually). The services must work alongside existing campus mental health programs, operate beyond standard business hours, and include proven clinical support and licensed professionals experienced with college students. Vendors must have at least five years of higher education mental health experience and provide software enabling collaboration with campus staff. The board must annually report student usage statistics system-wide and by institution to the legislature.
SB 203 regulates pharmacy benefit managers (PBMs) by requiring them to pay pharmacies within 30 days for electronic claims and 60 days for paper claims. It mandates that claims for 340B drugs (federally discounted medications) include specific identifiers for processing. The bill also prohibits PBMs from forcing pharmacies to join multiple networks or penalizing them for declining to join such networks. These provisions directly affect PBMs, pharmacies, and prescribers within the state’s health insurance system.
